Ecstasy is otherwise known as 3,4-methylenedioxymethamphetamine (MDMA)

Detection window – 48 hours. Screening is difficult.

Drug effects – tremulousness, anxiety, agitation, and palpitation. Watch carefully for arrhythmias. stroke, seizures, myocardial infarction, and sudden death have also been seen in patients abusing this drug.

Toxicity – manifests as nausea, tachycardia, hyperthermia, hypertension, polydipsia, anxiety, bruxism, and fatal effects like disseminated intravascular coagulation (DIC), seizures, or death. Be aware that polydipsia can lead to hyponatremia.

Treatment – treat hypertension and tachycardia with benzodiazepines. Cooling measures should be employed if the patient is hyperthermic.

False positives – Pseudoephedrine, Vicks inhaler

Substance abuse (general considerations) – If necessary, get your urine/blood screen early. The urine screen will take 30 minutes and a serum screen will be closer to an hour. Almost all drug screens will return results for marijuana, amphetamines/methamphetamines, phencyclidine (PCP), cocaine, opioids, barbiturates, and benzodiazepines. Generally speaking, if the patient is acutely intoxicated, the case should be cancelled/delayed. Refer to your facility to get policies on cancellations/delays.

Ecstacy is an amphetamine derivative that results in serotonin, dopamine, and norepinephrine release along with monoamine oxidase (MOA) inhibition. This drug is rarely taken in isolation.

Other names – X, M, E XTC, Rolls, Clarity, Adam, Lover’s speed, and hug drug.

Routes – oral ingestion, IV, snorting.

Recreational Effects – euphoria, hallucinations, increased sexual and social interest